Reducing My Milk Supply

My oh my, where do I begin! Well, for starters, reducing my milk supply took quite a lot of experimenting and adjusting to meet Aya's needs. One of the best ways to reduce an abundant milk supply is to keep the breasts full as long as possible. Full breasts send a message to the brain that they overdid it and don't need to continue producing so much. This may seem simple, but when you have a baby that needs to eat frequently, keeping breasts full is difficult.

The way to get around this problem is to try what they call block feeding. Basically, you only feed on one side for a given period of time and block out the other; by keeping the one breast full longer you decrease your supply while still feeding your baby. It is a bit of a guessing game as to how long to block out a side, but we started by switching every two feedings. Since I was feeding Aya every 2 1/2 to 3 hours, this meant I blocked out one breast for about 5-6 hours at a time. Now as you can imagine, when this time had elapsed and it was time to let Aya feed from the other breast, it was VERY full, TOO full. If I had let Aya simply feed from that side she would have been overwhelmed by the milk and received far too much foremilk--the whole reason for her discomfort to begin with. To get around this, I had to pump off the first 1-2 ounces of milk before I fed Aya a more balanced milk with the hindmilk she had been missing out on for too long. At first, it was a bit of an experiment as to how much milk I needed to pump off. Too much, and my body would continue to make far too much milk. However, too little, and Aya was a very unhappy little lady.

So, our goal was twofold--keep Aya calm and peaceful by pumping off some milk while still decreasing my milk supply. Slowly but surely my supply did decrease, and I got good at knowing when I had pumped just enough milk so that Aya would be comfortable. Like learning to make bread or ride a bicycle, I began to get the feel of a breast that was just right for feeding Aya in comfort. In time, I knew my supply was decreasing because I didn't have to pump off as much milk in the beginning. Sometimes I didn't have to pump at all, especially late in the day when milk supply naturally decreases.

The hardest thing about pumping for me was that I had to do it for night feedings. It was really difficult for me to listen to little hungry Aya scream while I sat next to a nightlight and pumped. It was exhausting and felt like too much work. Several times, I thought about quitting all together. The pump made my breasts sore at first too; I had to use lanolin again, and felt like I was starting over in some ways. Nursing was not relaxing for me at all. It was the opposite. It made me nervous as I waited to see Aya's reaction to a feeding. Would she be content and peaceful? Would she arch her back and scream? Would she gulp and choke? I had seen pictures of women feeding their babies and not one of them looked like the battle it was for me. It was hard to continue when I felt like I was the reason Aya was so upset and challenging.

Through the entire process, we watched Aya's stools closely as an indicator of whether or not she was receiving hindmilk. During this time, I was eager to change her diaper to see if her stools had changed from green to yellow. Finally, after nearly a week, they did, and we knew Aya was finally getting a more balanced meal at each feeding.

The most miraculous change during this experience was Aya's demeanor. She wasn't colicky, her milk just wasn't quite right. She went from being fidgety and irritable, always on the brink of a meltdown, to a happy, calm little lady. Her fists unclenched, her arms relaxed. And so did we.

A new diagnosis; not colic

After we learned from the pediatrician that Aya had colic, I decided I should also call our lactation consultant to get her advice. I didn't think that screaming after feeding was normal or okay. Mary Kay agreed, and after listening to Aya's symptoms, suggested I was probably producing too much milk and overwhelming Aya's little developing system. I loved the questions she asked to help address our situation. They felt important and comprehensive. They felt like they were pinpointing a problem and not just addressing symptoms. She wanted to know Aya's birth weight, discharge weight, current weight, and all the details of what her feedings were like. After listening thoughtfully, she said it seemed as though Aya might be gaining weight too quickly. She also said that because Aya was gulping and choking her way through feedings, my letdown was probably very fast and forceful which is common with oversupply. Additionally, Mary Kay wanted to know what Aya's stools were like. I told her they were green and had wondered why I never saw the mustard yellow ones I thought breastfeed babies were supposed to have. These green stools also turned out to be a sign of oversupply. And so, the education on oversupply began.

There are two different kinds of milk mother's produce, foremilk and hindmilk. Foremilk comes first; it is a thirst quencher, high in lactose, and looks like skim milk. Later in the feeding, the fat content in the milk increases with each letdown. This later, more calorie dense milk, is called the hindmilk. It is creamy and thicker, and higher in calories. That is why it is important babies learn to empty one breast before going to the next, so they get a balance of both kinds of milk. When a mother produces too much milk (or more than the baby needs), an imbalance of foremilk and hindmilk is the result. Babies' tummies fill up on the early foremilk and don't have enough room for the hindmilk that comes later in a feeding. This imbalance will cause gas, fussiness, colicky symptoms and possibly reflux. The fact I switched Aya to the other breast each time she came off of the first breast crying only made the problem worse. As I switched her to the other side she was once again overwhelmed by additional foremilk, making her tummy hurt more .

I was so happy to hear there may be help for our little Aya, and relief for us too. The process of decreasing my milk supply was about to begin.

6 weeks and colic

Both Dan and I have decided that at 6 weeks we hit rock bottom. Dan's best friend was visiting us from California, which was something I had planned for Dan to thank him for all of his support during our pregnancy. It also happened to be the week we had not planned for. I knew something wasn't right, but I couldn't put my finger on it. What we did know however was that our little Aya couldn't seem to sleep, she cried when she was awake, and she wasn't eating well. When I would try to nurse her she would come off the breast after a minute or two and scream. I would assume I must not have enough milk on that side and switch her to the other, only to watch Aya repeat the same actions. She would nurse frantically for a minute or two, come of the breast, and scream. I would try to burp her but nothing would happen and she would continue to cry and cry some more, before we would eventually be able to bounce her to sleep. I felt like I was always waiting for the next feeding in hopes everything would be better. I had counted on feeding being a relaxing time for me and Aya, but it ended up being the opposite. Feeding Aya wasn't relaxing at all; rather it was stressful. It made me anxious and it definitely didn't seem to calm our daughter.

So, we called our pediatrician. Our pediatrician was very kind. She listened to our story with gentle sighs and watched me feed Aya. She said she seemed to be latched on well, and she was encouraged that Aya had gained a lot of weight. She guessed Aya was showing signs of colic and gave us a long list of things we could try to soothe her. She told us to get help. I looked over at Dan and I saw tears streaming down his face. Dan never shows emotions in public and rarely with me. When I saw him, I started to cry too. As we left the doctor's office I used the bathroom and caught a glimpse of myself in the mirror. I looked so bad, and I really didn't even care. When we left the clinic, Aya finally fell asleep in her car seat. Dan and I looked at each other and almost without saying anything at all, both decided to just drive until she woke again. We called my mom and told her we needed help.